EDI 275 Segments and Elements for the Patient Information Standard

Research and Development:See the list of EDI 275 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 275 (Patient Information) document into a CSV file. If you are researching the 275s, you can view other trading partner's mapping specifications. You can also gain knowledge by researching all EDI document types. Jobisez LLC can also provide assistance if you need additional help.

Solutions:Are you looking to trade the EDI 275 transaction with one of your trading partners? Do you need an EDI VAN Savings solution to exchange the 275? Or perhaps you would like to use a Cloud-Based application, so you can plug your 275 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the EDI 275 by using the EDI Mobile Device solution.

The EDI 275 Segments and Elements

Segment

Description

Sect

Req

Max Loop

Max Usage

Pos

BGN

Beginning Segment

H

O

0

1

1

DTM

Date/Time Reference

H

O

0

3

2

TRN

Trace

H

O

0

5

3

NM1

Individual Or Organizational Name

H

O

999999

1

4

IN1

Individual Identification

H

O

0

1

5

DMG

Demographic Information

H

O

0

3

6

PRV

Provider Information

H

O

0

1

7

PER

Administrative Communications Contact

H

O

0

2

8

REF

Reference Information

H

O

0

5

9

DTP

Date Or Time Or Period

H

O

0

1

10

NX1

Property Or Entity Identification

H

O

5

1

11

N3

Party Location

H

O

0

1

12

N4

Geographic Location

H

O

0

1

13

LX

Transaction Set Line Number

D

O

999999

1

14

TRN

Trace

D

O

0

1

15

STC

Status Information

D

O

0

1

16

NM1

Individual Or Organizational Name

D

O

0

1

17

PRV

Provider Information

D

O

0

1

18

PER

Administrative Communications Contact

D

O

0

1

19

REF

Reference Information

D

O

0

5

20

DTP

Date Or Time Or Period

D

O

999999

1

21

CAT

Category Of Patient Information Service

D

O

0

1

22

PID

Product/Item Description

D

O

0

1

23

EFI

Electronic Format Identification

D

O

1

1

24

BIN

Binary Data Segment

D

M

0

1

25

Segment

Element

Description

Req

Min Length

Max Length

Type

BGN

1

Transaction Set Purpose Code

M

2

2

ID

BGN

2

Reference Identification

M

1

50

AN

BGN

3

Date

M

8

8

DT

BGN

4

Time

C

4

8

TM

BGN

5

Time Code

O

2

2

ID

BGN

6

Reference Identification

O

1

50

AN

BGN

7

Transaction Type Code

O

2

2

ID

BGN

8

Action Code

O

1

2

ID

BGN

9

Security Level Code

O

2

2

ID

DTM

1

Date/Time Qualifier

M

3

3

ID

DTM

2

Date

C

8

8

DT

DTM

3

Time

C

4

8

TM

DTM

4

Time Code

O

2

2

ID

DTM

5

Date Time Period Format Qualifier

C

2

3

ID

DTM

6

Date Time Period

C

1

35

AN

TRN

1

Trace Type Code

M

1

2

ID

TRN

2

Reference Identification

M

1

50

AN

TRN

3

Originating Company Identifier

O

10

10

AN

TRN

4

Reference Identification

O

1

50

AN

NM1

1

Entity Identifier Code

M

2

3

ID

NM1

2

Entity Type Qualifier

M

1

1

ID

NM1

3

Name Last Or Organization Name

C

1

60

AN

NM1

4

Name First

O

1

35

AN

NM1

5

Name Middle

O

1

25

AN

NM1

6

Name Prefix

O

1

10

AN

NM1

7

Name Suffix

O

1

10

AN

NM1

8

Identification Code Qualifier

C

1

2

ID

NM1

9

Identification Code

C

2

80

AN

NM1

10

Entity Relationship Code

C

2

2

ID

NM1

11

Entity Identifier Code

O

2

3

ID

NM1

12

Name Last Or Organization Name

O

1

60

AN

IN1

1

Entity Type Qualifier

M

1

1

ID

IN1

2

Name Type Code

M

2

2

ID

IN1

3

Entity Identifier Code

O

2

3

ID

IN1

4

Reference Identification Qualifier

C

2

3

ID

IN1

5

Reference Identification

C

1

50

AN

IN1

6

Individual Relationship Code

O

2

2

ID

IN1

7

Level Of Individual, Test, Or Course Code

O

2

2

ID

DMG

1

Date Time Period Format Qualifier

C

2

3

ID

DMG

2

Date Time Period

C

1

35

AN

DMG

3

Gender Code

O

1

1

ID

DMG

4

Marital Status Code

O

1

1

ID

DMG

5

Race Or Ethnicity Code

C

1

1

ID

DMG

6

Code List Qualifier Code

C

1

3

ID

DMG

7

Industry Code

C

1

30

AN

DMG

8

Citizenship Status Code

O

1

2

ID

DMG

9

Country Code

O

2

3

ID

DMG

10

Basis Of Verification Code

O

1

2

ID

DMG

11

Quantity

O

1

15

R

DMG

12

Code List Qualifier Code

C

1

3

ID

DMG

13

Industry Code

C

1

30

AN

PRV

1

Provider Code

M

1

3

ID

PRV

2

Reference Identification Qualifier

C

2

3

ID

PRV

3

Reference Identification

C

1

50

AN

PRV

4

State Or Province Code

O

2

2

ID

PRV

5

Provider Specialty Code

O

1

3

AN

PRV

6

Agency Qualifier Code

O

2

2

ID

PRV

7

Yes/No Condition Or Response Code

O

1

1

ID

PRV

8

Provider Organization Code

O

3

3

ID

PER

1

Contact Function Code

M

2

2

ID

PER

2

Name

O

1

60

AN

PER

3

Communication Number Qualifier

C

2

2

ID

PER

4

Communication Number

C

1

256

AN

PER

5

Communication Number Qualifier

C

2

2

ID

PER

6

Communication Number

C

1

256

AN

PER

7

Communication Number Qualifier

C

2

2

ID

PER

8

Communication Number

C

1

256

AN

PER

9

Contact Inquiry Reference

O

1

20

AN

REF

1

Reference Identification Qualifier

M

2

3

ID

REF

2

Reference Identification

C

1

50

AN

REF

3

Description

C

1

80

AN

REF

4

Reference Identification Qualifier

O

2

3

ID

REF

5

Reference Identification

O

1

50

AN

REF

6

Reference Identification Qualifier

O

2

3

ID

REF

7

Reference Identification

O

1

50

AN

REF

8

Reference Identification Qualifier

O

2

3

ID

REF

9

Reference Identification

O

1

50

AN

DTP

1

Date/Time Qualifier

M

3

3

ID

DTP

2

Date Time Period Format Qualifier

M

2

3

ID

DTP

3

Date Time Period

M

1

35

AN

NX1

1

Entity Identifier Code

M

2

3

ID

NX1

2

Entity Identifier Code

O

2

3

ID

NX1

3

Entity Identifier Code

O

2

3

ID

NX1

4

Entity Identifier Code

O

2

3

ID

NX1

5

Entity Identifier Code

O

2

3

ID

N3

1

Address Information

M

1

55

AN

N3

2

Address Information

O

1

55

AN

N4

1

City Name

O

2

30

AN

N4

2

State Or Province Code

C

2

2

ID

N4

3

Postal Code

O

3

15

ID

N4

4

Country Code

C

2

3

ID

N4

5

Location Qualifier

C

1

2

ID

N4

6

Location Identifier

O

1

30

AN

N4

7

Country Subdivision Code

C

1

3

ID

LX

1

Assigned Number

M

1

6

N0

TRN

1

Trace Type Code

M

1

2

ID

TRN

2

Reference Identification

M

1

50

AN

TRN

3

Originating Company Identifier

O

10

10

AN

TRN

4

Reference Identification

O

1

50

AN

STC

1

Industry Code

M

1

30

AN

STC

2

Industry Code

M

1

30

AN

STC

3

Entity Identifier Code

M

2

3

ID

STC

4

Code List Qualifier Code

M

1

3

ID

STC

5

Date

O

8

8

DT

STC

6

Action Code

O

1

2

ID

STC

7

Monetary Amount

O

1

18

R

STC

8

Monetary Amount

O

1

18

R

STC

9

Date

O

8

8

DT

STC

10

Payment Method Code

O

3

3

ID

STC

11

Date

O

8

8

DT

STC

12

Check Number

O

1

16

AN

STC

13

Industry Code

O

1

30

AN

STC

14

Industry Code

O

1

30

AN

STC

15

Entity Identifier Code

O

2

3

ID

STC

16

Code List Qualifier Code

O

1

3

ID

STC

17

Industry Code

O

1

30

AN

STC

18

Industry Code

O

1

30

AN

STC

19

Entity Identifier Code

O

2

3

ID

STC

20

Code List Qualifier Code

O

1

3

ID

STC

21

Free-Form Message Text

O

1

264

AN

NM1

1

Entity Identifier Code

M

2

3

ID

NM1

2

Entity Type Qualifier

M

1

1

ID

NM1

3

Name Last Or Organization Name

C

1

60

AN

NM1

4

Name First

O

1

35

AN

NM1

5

Name Middle

O

1

25

AN

NM1

6

Name Prefix

O

1

10

AN

NM1

7

Name Suffix

O

1

10

AN

NM1

8

Identification Code Qualifier

C

1

2

ID

NM1

9

Identification Code

C

2

80

AN

NM1

10

Entity Relationship Code

C

2

2

ID

NM1

11

Entity Identifier Code

O

2

3

ID

NM1

12

Name Last Or Organization Name

O

1

60

AN

PRV

1

Provider Code

M

1

3

ID

PRV

2

Reference Identification Qualifier

C

2

3

ID

PRV

3

Reference Identification

C

1

50

AN

PRV

4

State Or Province Code

O

2

2

ID

PRV

5

Provider Specialty Code

O

1

3

AN

PRV

6

Agency Qualifier Code

O

2

2

ID

PRV

7

Yes/No Condition Or Response Code

O

1

1

ID

PRV

8

Provider Organization Code

O

3

3

ID

PER

1

Contact Function Code

M

2

2

ID

PER

2

Name

O

1

60

AN

PER

3

Communication Number Qualifier

C

2

2

ID

PER

4

Communication Number

C

1

256

AN

PER

5

Communication Number Qualifier

C

2

2

ID

PER

6

Communication Number

C

1

256

AN

PER

7

Communication Number Qualifier

C

2

2

ID

PER

8

Communication Number

C

1

256

AN

PER

9

Contact Inquiry Reference

O

1

20

AN

REF

1

Reference Identification Qualifier

M

2

3

ID

REF

2

Reference Identification

C

1

50

AN

REF

3

Description

C

1

80

AN

REF

4

Reference Identification Qualifier

O

2

3

ID

REF

5

Reference Identification

O

1

50

AN

REF

6

Reference Identification Qualifier

O

2

3

ID

REF

7

Reference Identification

O

1

50

AN

REF

8

Reference Identification Qualifier

O

2

3

ID

REF

9

Reference Identification

O

1

50

AN

DTP

1

Date/Time Qualifier

M

3

3

ID

DTP

2

Date Time Period Format Qualifier

M

2

3

ID

DTP

3

Date Time Period

M

1

35

AN

CAT

1

Report Type Code

O

2

2

ID

CAT

2

Report Transmission Code

C

1

2

ID

CAT

3

Version Identifier

O

1

30

AN

CAT

4

Code List Qualifier Code

C

1

3

ID

CAT

5

Industry Code

C

1

30

AN

CAT

6

Industry Code

O

1

30

AN

CAT

7

Version Identifier

O

1

30

AN

PID

1

Item Description Type

M

1

1

ID

PID

2

Product/Process Characteristic Code

O

2

3

ID

PID

3

Agency Qualifier Code

C

2

2

ID

PID

4

Product Description Code

C

1

12

AN

PID

5

Description

C

1

80

AN

PID

6

Surface/Layer/Position Code

O

2

2

ID

PID

7

Source Subqualifier

O

1

15

AN

PID

8

Yes/No Condition Or Response Code

O

1

1

ID

PID

9

Language Code

O

2

3

ID

EFI

1

Security Level Code

M

2

2

ID

EFI

2

Free-Form Message Text

O

1

264

AN

EFI

3

Security Technique Code

O

2

2

ID

EFI

4

Version Identifier

C

1

30

AN

EFI

5

Program Identifier

O

1

30

AN

EFI

6

Version Identifier

C

1

30

AN

EFI

7

Interchange Format

O

1

30

AN

EFI

8

Version Identifier

C

1

30

AN

EFI

9

Compression Technique

O

1

30

AN

EFI

10

Drawing Sheet Size Code

O

2

2

AN

EFI

11

File Name

O

1

64

AN

EFI

12

Block Type

O

1

4

AN

EFI

13

Record Length

O

1

15

N0

EFI

14

Block Length

O

1

5

N0

EFI

15

Version Identifier

C

1

30

AN

EFI

16

Filter Id Code

C

3

3

ID

BIN

1

Length Of Binary Data

M

1

15

N0

BIN

2

Binary Data

M

1

4096

B

Official Definition:Data contents of the Patient Information Transaction Set (275) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate individual patient information requests and patient information (either solicited or unsolicited) between separate health care entities in a variety of settings to be consistent with confidentiality and use requirements. Patient information consists of demographic, clinical, and other supporting data.